Name: Whangarei Club Coaching Day
Start: 2017-11-25T08:00:00+13:00
End: 2017-11-25T17:00:00+13:00
Location: Whangarei

Your Details

Riders Full Name*

Date of Birth*

Parents Name (if under 18)

Email Address*

Phone Number*

(e.g. 09 1234567)

The region you are from*

Have you been coached by us in the last 12 months?

Have you been coached by us in the last 12 months?*

Yes
No

Your Experience

What year did you first start riding? (eg. 2010)

What year did you first start racing? (if applicable)

What is the main type of riding that you do?

Motocross
Trail
Cross-country
Endurance
Supercross
Freestyle

How would you rate your ability?

What type of bike do you ride?

Coaching preferences

Select as many as you want.

1 on 1
1 on 2
1 on 3
Group

Any Comments

Please tell us if you have any special requirements or if there is anything else you'd like us to know (e.g 1 on 1 preference, start time preference etc).

Yes! Subscribe me to the Broxy Newsletter

Terms and Conditions / Waiver

Indemnity: I irrevocably indemnify Broxy Rider Coaching, Blue Wing Honda, Peter Broxholme, land owners, officials and employees against any and all actions, claims, suits, proceedings, demands, liabilities, damages, payments, losses, costs, injuries and expenses arising from our attendance at this event. They are absolved from any liability arising out of any accidents however caused, resulting in damage and/or personal injury.

*

I have read and agree to the Terms and Conditions *

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Whangarei Club Coaching Day

25 November 2017 @ 8:00 am - 5:00 pm

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Your Details

Have you been coached by us in the last 12 months?

Your Experience

Any Comments

Terms and Conditions / Waiver

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